Know Your Risk
Should I get tested for BRCA?
Not everyone needs to be tested for BRCA. In fact, most cancer is NOT due to inherited mutations such as BRCA. One or two cases of breast or ovarian cancer in a family does not automatically signal the presence of a BRCA gene mutation in your family. Only about 5-10% of all breast cancer cases and 10% of ovarian cases are due to a BRCA mutation.
It is important to meet with a genetic counselor or other genetic specialist to examine your family health history when deciding to get tested for a BRCA gene mutation. The mutation can be passed down from either side of the family, so when looking at your family medical history, you need to consider relatives on both your mother’s and your father’s sides of the family. It is good to examine at least three generations of medical history if that information is available.
The likelihood that breast and/or ovarian cancer is associated with BRCA1 or BRCA2 is highest in families with a history of multiple cases of breast cancer, cases of both breast and ovarian cancer, one or more family members with two primary cancers (original tumors at different sites), early age of onset of cancers, or an Ashkenazi (Eastern European) Jewish background. However, not every woman in such families carries an alteration in BRCA1 or BRCA2, and not every cancer in such families is linked to alterations in these genes.
Signs that there may be a BRCA mutation in your family include but are not limited to:
- You or a family member have been diagnosed with breast cancer at an earlier age than usual (before age 50)
- You or a family member have been diagnosed with breast cancer in both breasts at any age
- You or a family member have developed two or more separate cancers (for example, a woman who develops breast cancer and then later ovarian cancer)
- Two or more of your relatives in the same blood line have been diagnosed with breast or ovarian cancer, especially if the breast cancer was diagnosed at or before age 50
- Breast cancer in men
- There is a family history of breast or ovarian cancer and your family is of Ashkenazi Jewish descent
- A number of relatives on the same side of the family with breast or ovarian cancer and one of either prostate, pancreatic or melanoma cancers.
- There is a known BRCA mutation in your family. (Thus, there IS a BRCA mutation in your family, and that means you MAY have a BRCA mutation)
Other factors may indicate a hereditary cancer syndrome within a family. It is important to seek the opinion of a specialist in cancer genetics if you believe the cancer in your family may be hereditary.
For more information on understanding your Risk of BRCA mutation, please visit:
BRCA Risk Calculator
by Myriad Genetics
Risk Mutation Prevalence Tables
by Myriad Genetics
Genetic Risk Assessment and BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility
by U.S. Preventive Services Task Force
The Risk of Cancer Associated with Specific Mutations of BRCA1 and BRCA2 among Ashkenazi Jews
by The New England Journal of Medicine
How do I take a Family Health History?
Health care professionals have known for a long time that common diseases – like breast cancer, and diabetes - and even rare diseases can run in families and be passed on through the generations. A Family Health History is collected by speaking with your maternal (mom’s side) AND paternal (dad’s side) family members: parents, grandparents, cousins, aunts, uncles, etc, to learn about common diseases that have appeared throughout the generations in your family. Tracing the illnesses suffered by your parents, grandparents, and other blood relatives can help your doctor predict the disorders for which you may be at risk and suggest actions to keep you and your family healthy. There are MANY tools available on the computer, both on-line (interactive) and downloadable, designed to help people collect information to share with health professionals to discuss your history.
You can use one of the tools listed below as an aid to discuss your family’s health history and then take your findings with you to your healthcare provider:
My family health portrait
by the US Surgeon General
Create your family tree tool
by My Family Health
Family Health History Resources
(a comprehensive listing and guide of quality family health history tools) by Genetic Alliance
Family History: Resources and Tools
(a listing of tools to help you take your family health history) by Center for Disease Control
Should I talk to a Genetic Counselor?
We highly recommend visiting a genetic counselor or genetic specialist before undergoing decisions about genetic testing. Genetic counselors and genetic specialists will help you learn about your risks of developing cancer and the best ways that you can screen for them. They can discuss whether or not genetic testing may at all be useful to you and if so, help you to make a decision about whether or not you would want to undergo testing.
Genetic Counselors and Specialists are trained to help interpret the different outcomes that can result from testing for BRCA and other genetic conditions. Genetic Counselors and Specialists offer expert advice on what to do in your specific circumstances, and help you work through your thoughts and feelings about the decisions associated with your cancer risk.
For more information on how a Genetic specialist can help, and to find a Genetic Counselor or an Advanced Practice Nurse in Genetics near you, visit:
Find a Genetic Counselor in your Area
by the National Society of Genetic Counselors
How to Find a Genetic Counselor
by Genetic Health
Frequently Asked Questions About Genetic Counseling
by The National Human Genome Research Institute
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